Exercise prescription

Question 1

Why do we prescribe exercise

Answer 1

Confidence, improve tendon capacity, proprioception, pain management, neuromuscular facilitation, ROM, improve aerobic fitness/power, mental health, bone density, motor learning, weight loss, reduce risk of falls, increase muscle mass/endurance, improve sleep quality, improve joint quality, aesthetics. improve function/agility

Question 2

Impact of inactivity

Answer 2

physical inactivity has a significant impact on morbidity and mortality
Physically inactive people use healthcare resources more than active people, MSK complaints reduce up to 77% with weight loss

Question 3

How to maximise exercise prescription

Answer 3

Individualise it- based on fears/ beliefs/ experiences
Keep it simple- build capacity first, control/complexity later
Keep it challenging- based on exertion, fear, or pain
Be patient- 12+ weeks,

Question 4

Keeping exercises simple

Answer 4

Foundations of rehab: restore normal movement, increase the patient’s confidence, capacity, tolerance, or resilience to the movement or task
Dont overload too many exercises
realistic timing

Question 5

keep it challenging

Answer 5

load- increase weight/resistance, effort- increase intensity of the exercise and walking speeds act, dosage- change parameters of reps/sets as patients capacity changes, frequency- how many times per week, volume- how much focus on strength vs proprioception vs flexibility

Question 6

factors that can affect tissue adaptations

Answer 6

previous history of pain, overall health (obesity, smoking, drinking), comorbidities, exercise tolerance, pain beliefs, fear avoidance, catastrophising, lack of self-efficacy

Question 7

Be patient

Answer 7

set expectations and educate the patient.

Question 8

the perfect rehab programme

Answer 8

simple- not too many
goal orientated
functional exercise
challenging
time matches patient expectations

Question 9

compliance- 6 ffactors

Answer 9

patient understanding of exercises- “do you understand why you are doing this?”
Physio verbal and visual explanation of exercises
physio explanation quality- set expectations (do they understand- information leaflet)
Reassessment of exercises- re assess functional goals- progression
satisfaction with physio- build rapport